Halitosis, or bad breath, is a term used to describe noticeably unpleasant odors exhaled in breathing – whether the smell is from an oral source due to bacteria or otherwise. Halitosis has a significant impact – personally and socially – on those who suffer from it or believe they do (halitophobia), and is estimated to be the third-most-frequent reason for seeking dental aid, following tooth decay and periodontal disease.
General
In most cases (85–90%), bad breath originates in the mouth itself. The intensity of bad breath differs during the day, due to eating certain foods (such as garlic, onions, meat, fish, and cheese), obesity, smoking, and alcohol consumption.[3][4] Because the mouth is exposed to less oxygen and is inactive during the night, the odor is usually worse upon awakening ("morning breath"). Bad breath may be transient, often disappearing following eating, brushing one's teeth, flossing, or rinsing with specialized mouthwash The latest technolgy of bad breath have made a big leap forward which led to eBook advice from sites like badhalitosisbreath. com and oraltech. com.au
Bad breath may also be persistent (chronic bad breath), which is a more serious condition, affecting some 25% of the population in varying degrees.[5] It can negatively affect the individual's personal, social, and business relationships, leading to poor self-esteem and increased stress.
Listerine can lay claim to the origins of the word halitosis, which is a combination of the Latin halitus, meaning 'breath', and the Greek suffix osis often used to describe a medical condition, e.g., 'cirrhosis of the liver'.
The term 'halitosis' was introduced by Listerine in 1921. But bad breath is not a modern affliction; it has been causing embarrassment for thousands of years. Records mentioning bad breath have been discovered more than 3,000 years ago, all the way back in 1550 B.C. Back then, exactly what caused bad breath was not known, but a mouthwash of wine and herbs was one recommended way of solving the problem[citation needed].
Origins
Mouth
There are over 600 types of bacteria found in the average mouth. Several dozen of these can produce high levels of foul odors when incubated in the laboratory. The odors are produced mainly due to the anaerobic breakdown of proteins into individual amino acids, followed by the further breakdown of certain amino acids to produce detectable foul gases. For example, the breakdown of cysteine and methionine produce hydrogen sulfide and methyl mercaptan, respectively. Volatile sulfur compounds have been shown to be statistically associated with oral malodor levels, and usually decrease following successful treatment.[6]
Other parts of the mouth may also contribute to the overall odor, but are not as common as the back of the tongue. These locations are, in order of descending prevalence: inter-dental and sub-gingival niches, faulty dental work, food-impaction areas in-between the teeth, abscesses, and unclean dentures.[7] Oral based lesions caused by viral infections like Herpes Simplex and HPV may also contribute to bad breath.
Tongue
The most common location for mouth-related halitosis is the tongue. Tongue bacteria produce malodorous compounds and fatty acids, and account for 80 to 90 percent of all cases of mouth-related bad breath[9]. Large quantities of naturally-occurring bacteria are often found on the posterior dorsum of the tongue, where they are relatively undisturbed by normal activity. This part of the tongue is relatively dry and poorly cleansed, and bacterial populations can thrive on remnants of food deposits, dead epithelial cells, and postnasal drip. The convoluted microbial structure of the tongue dorsum provides an ideal habitat for anaerobic bacteria, which flourish under a continually-forming tongue coating of food debris, dead cells, postnasal drip and overlying bacteria, living and dead. When left on the tongue, the anaerobic respiration of such bacteria can yield either the putrescent smell of indole, skatole, polyamines, or the "rotten egg" smell of volatile sulfur compounds (VSCs) such as hydrogen sulfide, methyl mercaptan, Allyl methyl sulfide, and dimethyl sulfide.
Cleaning the tongue
The most widely-known reason to clean the tongue is for the control of bad breath. Methods used against bad breath, such as mints, mouth sprays, mouthwash or gum, may only temporarily mask the odors created by the bacteria on the tongue, but cannot cure bad breath because they do not remove the source of the bad breath. In order to prevent the production of the sulfur-containing compounds mentioned above, the bacteria on the tongue must be removed, as most the decaying food debris present on the rear areas of the tongue. Most people who clean their tongue use a tongue cleaner (tongue scraper), or a toothbrush. Specially designed tongue cleaners are a lot more effective (collecting and removing the bacterial coating) than toothbrushes (which merely spread the bacterial accumulations on the tongue and in the mouth)[citation needed].
Gum disease
There is some controversy over the role of periodontal diseases in causing bad breath. Whereas bacteria growing below the gumline (subgingival dental plaque) have a foul smell upon removal, several studies reported no statistical correlation between malodor and periodontal parameters.[10][11]
Nose
The second major source of bad breath is the nose. In this occurance, the air exiting the nostrils has a pungent odor that differs from the oral odor. Nasal odor may be due to sinus infections or foreign bodies.[6][7]
Tonsils
In general, putrefaction from the tonsils is considered a minor cause of bad breath, contributing to some 3-5% of cases. Approximately 7% of the population suffer from small bits of calcified matter in tonsillar crypts called tonsilloliths that smell extremely foul when released and can cause bad breath.
Esophagus
The Cardia, which is the valve between the stomach and the esophagus, may not close properly due to a Hiatal Hernia or GERD, allowing acid to enter the esophagus and gases escape to the mouth.
Stomach
The stomach is considered by most researchers as a very uncommon source of bad breath (except in belching). The esophagus is a closed and collapsed tube, and continuous flow (as opposed to a simple burp) of gas or putrid substances from the stomach indicates a health problem - such as reflux serious enough to be bringing up stomach contents or a fistula between the stomach and the esophagus - which will demonstrate more serious manifestations than just foul odor.
In the case of allyl methyl sulfide, odor does come from the stomach, since it does not get metabolized there
Bad breath sufferers should feel encouraged to seek treatment because of the high success rate in managing the problem.